Private hospitals invited as Tier 1 providers under Malaysia’s MHIT base plan


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PETALING JAYA: Private hospitals nationwide have been invited to participate as Tier 1 providers under the Malaysia Health Insurance Transformation (MHIT) base plan, with a pilot programme in the Greater Klang Valley scheduled to start in stages from July this year.

Health Minister Datuk Seri Dr Dzulkefly Ahmad said the invitation extends to all private hospitals, and is not limited to those that attended a recent Joint Ministerial Committee on Private Healthcare Costs meeting.

The session, which he co-chaired with Finance Minister II Datuk Seri Amir Hamzah Azizan and was attended by Bank Negara Malaysia representatives and chief executive officers of private hospitals, was described as both collaborative and productive.

As part of the initiative, participating hospitals are required to submit key operational and clinical data to support the phased implementation of Diagnosis-Related Groups (DRGs) as the basis for payments beginning January 2027.

Dr Dzulkefly said the adoption of DRGs is expected to enhance pricing transparency and predictability, while helping Malaysia move away from the traditional fee-for-service model towards value-based healthcare that prioritises patient outcomes.

“Private hospital CEOs have expressed their commitment to submit the needed data expeditiously so that we can implement DRGs in a data-driven and orderly manner,” he said in a post on his X account on Saturday (April 4).

He added that the Health Ministry is also reviewing licensing and regulatory processes under the Private Healthcare Facilities and Services Act 1998 (Act 586).

This review follows feedback from industry players that existing procedures are too lengthy and drive up operational costs, which are ultimately passed on to patients.

On digital health, Dr Dzulkefly reiterated that it remains a critical enabler across the healthcare ecosystem. Efforts are underway to link public and private healthcare systems under a data governance framework that ensures individuals retain control over their personal information.

He also invited stakeholders to join the Malaysia Digital Health Certification Network (MDHCN), noting that initiatives such as sharing radiology images can help avoid duplicate tests and reduce overall costs.

Dr Dzulkefly stressed that Malaysia’s public and private healthcare sectors must continue to complement each other by expanding access and choice for patients.

However, he emphasised that private sector initiatives will not replace the public healthcare system, which remains the backbone of the country’s universal health coverage.

“The public healthcare system remains our bedrock, supported by the largest budget allocation to date and continuing to grow,” he said.

He added that the ongoing transformation in health financing reflects a whole-of-nation approach, aimed not only at addressing private-sector medical inflation but also at driving comprehensive reform across the healthcare system.

 

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